Bilateral Endophthalmitis in a Postpartum Immunocompetent Patient

TL;DR

A postpartum woman developed bilateral endophthalmitis with no identified infection source, but recovered full vision after treatment.

Contribution

First reported case of bilateral postpartum endophthalmitis in an immunocompetent patient with negative cultures.

Findings

Bilateral endophthalmitis occurred in a postpartum patient with no prior surgeries or comorbidities.

No infectious source was identified despite negative culture results from vitreous and aqueous samples.

Early vitrectomy and intravitreal treatment led to full visual recovery despite residual fibrosis.

Abstract

The aim of this report is to present the onset of bilateral endophthalmitis negative to culture testing and vitreous tapping in a postpartum immunocompetent patient.

A 33-year-old patient developed floaters and severe blurry vision in both eyes 3 weeks after childbirth. With no previous surgery, no comorbidities in her clinical history, and negative diagnostic reports, endogenous endophthalmitis was suspected. Two days later, a pars plana vitrectomy was performed in both eyes one week apart, and intravitreal antibiotics and antifungals were administered during the surgery. No infectious source was identified since the cultures from the aqueous and vitreous humor returned negative in both cases.

Residual fibrosis around the fovea in the right eye and on the optic disc in the left eye was described. Nevertheless, the best corrected visual acuity of the patient was 20/20 in both eyes 4 months after the onset of the presumed endogenous endophthalmitis.

This is the first report presenting a bilateral case of postpartum endophthalmitis negative to culture testing and vitreous tapping in a healthy patient with no previous surgeries nor long-term treatment. Early pars plana vitrectomy was fundamental for the correct management of this condition.

Figures